Department of Ophthalmology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
Retina. 2010 Feb;30(2):305-9.
The purpose of this study was to evaluate the surgical outcome of combined hamartomas of the retina and retinal pigment epithelium in five patients.
In this interventional retrospective case series study, five patients with combined hamartomas of the retina and retinal pigment epithelium received vitrectomy and epiretinal component peeling. Pre- and postoperative best-corrected visual acuity, fundus examination, photography and fundus fluorescein angiography, optical coherence tomography, and B-ultrasound scan examination were analyzed.
The 5 patients were all men, ranging in age from 6 years to 21 years (mean 12.6 +/- 6.5 years). The lesions were unilateral. Preoperative best-corrected visual acuity ranged from 20/340 to 20/50 (median 20/200), and postoperative best-corrected visual acuity ranged from 20/340 to 20/30 (median 20/100). Best-corrected visual acuity improved in 3 patients (60%) after the surgeries and remained unchanged in 2 patients. Epiretinal components were completely removed, except for a small residual membrane left in two cases. Tortuosity of the retinal vessels improved in all the cases after the surgeries. Fundus fluorescein angiography showed reduction in vascular tortuosity and decrease of dye leakage. Optical coherence tomography demonstrated disappearance or reduction of high reflectivity of the inner retina and decrease of underlying retina edema. In two cases, the only complication was temporary ocular hypertension.
Selected patients with combined hamartomas of the retina and retinal pigment epithelium may benefit from surgical management at the appropriate time.
本研究旨在评估 5 例视网膜和视网膜色素上皮联合错构瘤患者的手术效果。
在这项回顾性干预研究中，5 例视网膜和视网膜色素上皮联合错构瘤患者接受了玻璃体切除术和视网膜外膜剥离术。分析了术前和术后最佳矫正视力、眼底检查、照相和眼底荧光血管造影、光学相干断层扫描和 B 超扫描检查。
5 例患者均为男性，年龄 6 至 21 岁（平均 12.6 +/- 6.5 岁）。病变均为单侧。术前最佳矫正视力为 20/340 至 20/50（中位数 20/200），术后最佳矫正视力为 20/340 至 20/30（中位数 20/100）。3 例（60%）患者术后最佳矫正视力提高，2 例患者保持不变。视网膜外膜完全切除，仅在 2 例中残留一小部分膜。手术后所有病例视网膜血管迂曲均有改善。眼底荧光血管造影显示血管迂曲减少，染料渗漏减少。光学相干断层扫描显示内视网膜高反射消失或减少，视网膜下水肿减轻。2 例患者仅出现短暂性眼压升高。
选择合适时机手术治疗视网膜和视网膜色素上皮联合错构瘤患者可能有益。
